RESUMEN
PURPOSE: To examine changes in vision-related quality of life after implantable Collamer lens (ICL) implantation for the correction of myopia. DESIGN: Prospective, interventional, consecutive case series. PARTICIPANTS: We included 34 consecutive patients (68% female; mean age, 37 years [range, 23-49]) with preoperative myopia (mean ± standard deviation [SD] refraction spherical equivalent, -11.0 ± 3.12). INTERVENTION: Bilateral ICL implantation. MAIN OUTCOME MEASURES: Quality of life Impact of Refractive Correction (QIRC) score. RESULTS: The median postoperative interval before questionnaire administration was 4 months (range, 3-7). The QIRC scores were significantly higher postoperatively (preoperative QIRC score [mean ± SD], 40.45 ± 4.83; postoperative QIRC score 53.79 ± 5.60; P < 0.001), with significant improvements (P<0.01) for 14 of 19 items. Nineteen (58%) patients reported a worsening in night vision symptoms (mostly nonspecific glare and halo or arc effects) after surgery, but overall levels of satisfaction were high; 88% were either satisfied or very satisfied with the results of surgery. No patients reported overall dissatisfaction. In free text responses, 11 patients (32%) described ICL implantation as life changing or wished that they had opted for the surgery sooner. CONCLUSIONS: Implantation of an ICL for myopia is associated with significant improvements in quality of life. Any dissatisfaction with the procedure largely relates to night vision symptoms, which are common in the early postoperative period.
Asunto(s)
Implantación de Lentes Intraoculares , Miopía Degenerativa/psicología , Miopía Degenerativa/cirugía , Lentes Intraoculares Fáquicas , Calidad de Vida/psicología , Adulto , Lentes de Contacto/estadística & datos numéricos , Femenino , Deslumbramiento , Humanos , Complicaciones Intraoperatorias , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Complicaciones Posoperatorias , Estudios Prospectivos , Encuestas y Cuestionarios , Agudeza Visual/fisiología , Adulto JovenRESUMEN
Central toxic keratopathy is an uncommon complication after laser in situ keratomileusis. We report the confocal microscopy findings in a case of central toxic keratopathy that confirm loss of keratocytes from the corneal stromal bed in the acute phase, with gradual repopulation over the following year.
Asunto(s)
Apoptosis , Queratocitos de la Córnea/patología , Opacidad de la Córnea/etiología , Sustancia Propia/patología , Queratomileusis por Láser In Situ , Láseres de Excímeros/uso terapéutico , Complicaciones Posoperatorias , Opacidad de la Córnea/fisiopatología , Humanos , Masculino , Microscopía Confocal , Persona de Mediana Edad , Remisión Espontánea , Trastornos de la Visión/etiología , Trastornos de la Visión/fisiopatología , Agudeza Visual/fisiologíaRESUMEN
A retrospective review of case notes of consecutive patients referred to a contact lens clinic after unsuccessful refractive surgery was carried out to determine the success of contact lens fitting. The main outcome variables in determining success were visual improvement, contact lens tolerance, fitting characteristics and wearing time. Thirteen eyes were fitted with conventional rigid gas permeable (CRGP), 10 with soft and 19 with reverse geometry rigid gas permeable contact lenses (RVG). The mean spectacle visual acuity (VA) was 6/9 (20/30) [range: 6/24 (20/80) to 6/5 (20/15)] and the mean VA after contact lens fitting was 6/6 (20/20) [range: 6/18 (20/60) to 6/5 (20/15)]. Of the 42 eyes, the contact lens VA was better than spectacle acuity in 25 (59.5%) eyes, equal in 14 (33.3%) and worse in three (7.1%). A total of 33 (78.6%) eyes were still wearing their lenses at the last visit. Contact lenses can be a valuable method of managing poor VA after refractive surgery.